Bill Text: MN HF824 | 2013-2014 | 88th Legislature | Introduced
Bill Title: Minnesota Health Records Act provisions modified.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2014-03-06 - Author added Zerwas [HF824 Detail]
Download: Minnesota-2013-HF824-Introduced.html
1.2relating to health; modifying provisions of the Minnesota Health Records Act;
1.3amending Minnesota Statutes 2012, sections 72A.501, subdivision 4; 72A.502,
1.4subdivision 6; 144.291, subdivision 2; 144.293, subdivisions 2, 3, 5, 8; 144.295,
1.5subdivision 1.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. Minnesota Statutes 2012, section 72A.501, subdivision 4, is amended to read:
1.8 Subd. 4. Authorization; noninsurers. If an authorization is submitted to an insurer,
1.9insurance-support organization, or insurance agent by a person other than an insurer,
1.10insurance-support organization, or insurance agent, the authorization must be dated, and
1.11 signed by the person, andobtained one year or less before the date a disclosure is sought
1.12 is valid for one year, or for a period specified in the authorization, or for a period as
1.13provided in law.
1.14 Sec. 2. Minnesota Statutes 2012, section 72A.502, subdivision 6, is amended to read:
1.15 Subd. 6. Other laws or order. Personal or privileged information may be disclosed
1.16without a written authorization if permitted or required by another state or federal law or
1.17 regulation or in response to a facially valid administrative or judicial order, including a
1.18search warrant or subpoena.
1.19 Sec. 3. Minnesota Statutes 2012, section 144.291, subdivision 2, is amended to read:
1.20 Subd. 2. Definitions. For the purposes of sections144.291 to
144.298 , the following
1.21terms have the meanings given.
1.22 (a) "Group purchaser" has the meaning given in section62J.03 , subdivision 6.
2.1 (b) "Health information exchange" means a legal arrangement between health care
2.2providers and group purchasers to enable and oversee the business and legal issues
2.3involved in the electronic exchange of health records between the entities for the delivery
2.4of patient care.
2.5 (c) "Health record" means anyinformation, whether oral or recorded in any form or
2.6medium, that relates to the past, present, or future physical or mental health or condition of
2.7a patient; the provision of health care to a patient; or the past, present, or future payment for
2.8the provision of health care to a patient protected health information as defined in HIPAA.
2.9 (d) "HIPAA" means the Health Insurance Portability and Accountability Act of 1996,
2.10title II, subtitle F, as amended and including federal regulations adopted under that act.
2.11(d) (e) "Identifying information" means the patient's name, address, date of birth,
2.12gender, parent's or guardian's name regardless of the age of the patient, and other
2.13nonclinical data which can be used to uniquely identify a patient.
2.14(e) (f) "Individually identifiable form" means a form in which the patient is or can be
2.15identified as the subject of the health records.
2.16(f) (g) "Medical emergency" means medically necessary care which is immediately
2.17needed to preserve life, prevent serious impairment to bodily functions, organs, or parts,
2.18or prevent placing the physical or mental health of the patient in serious jeopardy.
2.19(g) (h) "Patient" means a natural person who has received health care services from
2.20a provider for treatment or examination of a medical, psychiatric, or mental condition,
2.21the surviving spouse and parents of a deceased patient, or a person the patient appoints in
2.22writing as a representative, including a health care agent acting according to chapter 145C,
2.23unless the authority of the agent has been limited by the principal in the principal's health
2.24care directive. Except for minors who have received health care services under sections
2.25144.341
to
144.347 , in the case of a minor, patient includes a parent or guardian, or a
2.26person acting as a parent or guardian in the absence of a parent or guardian.
2.27(h) (i) "Provider" means:
2.28 (1) any person who furnishes health care services and is regulated to furnish the
2.29services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148D, 148F, 150A,
2.30151, 153, or 153A;
2.31 (2) a home care provider licensed under section144A.46 ;
2.32 (3) a health care facility licensed under this chapter or chapter 144A; and
2.33 (4) a physician assistant registered under chapter 147A.
2.34(i) (j) "Record locator service" means an electronic index of patient identifying
2.35information that directs providers in a health information exchange to the location of
2.36patient health records held by providers and group purchasers.
3.1(j) (k) "Related health care entity" means an affiliate, as defined in section
144.6521,
3.2subdivision 3 , paragraph (b), of the provider releasing the health records.
3.3 Sec. 4. Minnesota Statutes 2012, section 144.293, subdivision 2, is amended to read:
3.4 Subd. 2. Patient consent to release of records. A provider, or a person who
3.5receives health records from a provider, may not release a patient's health records to a
3.6personwithout:
3.7 (1) without a signed and dated consent from the patient or the patient's legally
3.8authorized representative authorizing the release;
3.9 (2) unless permitted or required under HIPAA or specific authorization in other
3.10applicable federal or state law; or
3.11 (3) without a representation from a provider that holds a signed and dated consent
3.12from the patient authorizing the release.
3.13 Sec. 5. Minnesota Statutes 2012, section 144.293, subdivision 3, is amended to read:
3.14 Subd. 3. Release from one provider to another. In addition to release or disclosure
3.15of health records authorized under subdivision 2, a patient's health record, including, but
3.16not limited to, laboratory reports, x-rays, prescriptions, and other technical information
3.17used in assessing the patient's condition, or the pertinent portion of the record relating to
3.18a specific condition, or a summary of the record, shall promptly be furnished to another
3.19provider upon the written request of the patient. The written request shall specify the name
3.20of the provider to whom the health record is to be furnished. The provider who furnishes
3.21the health record or summary may retain a copy of the materials furnished. The patient
3.22shall be responsible for the reasonable costs of furnishing the information.
3.23 Sec. 6. Minnesota Statutes 2012, section 144.293, subdivision 5, is amended to read:
3.24 Subd. 5. Exceptions to consent requirement. In addition to release or disclosure of
3.25health records authorized under subdivision 2, this section does not prohibit the release of
3.26health records:
3.27 (1) for a medical emergency when the provider is unable to obtain the patient's
3.28consent due to the patient's condition or the nature of the medical emergency;
3.29 (2) to other providerswithin or related health care entities when necessary for the
3.30current treatment of the patient; or
3.31 (3) to a health care facility licensed by this chapter, chapter 144A, or to the same
3.32types of health care facilities licensed by this chapter and chapter 144A that are licensed
3.33in another state when a patient:
4.1 (i) is returning to the health care facility and unable to provide consent; or
4.2 (ii) who resides in the health care facility, has services provided by an outside
4.3resource under Code of Federal Regulations, title 42, section 483.75(h), and is unable
4.4to provide consent.
4.5 Sec. 7. Minnesota Statutes 2012, section 144.293, subdivision 8, is amended to read:
4.6 Subd. 8. Record locator service. (a) In addition to release or disclosure of health
4.7records authorized under subdivision 2, a provider or group purchaser may release patient
4.8identifying information and information about the location of the patient's health records
4.9to a record locator service without consent from the patient, unless the patient has elected
4.10to be excluded from the service under paragraph (d). The Department of Health may not
4.11access the record locator service or receive data from the record locator service. Only a
4.12provider may have access to patient identifying information in a record locator service.
4.13Except in the case of a medical emergency, a provider participating in a health information
4.14exchange using a record locator service does not have access to patient identifying
4.15information and information about the location of the patient's health records unless the
4.16patient specifically consents to the access. A consent does not expire but may be revoked
4.17by the patient at any time by providing written notice of the revocation to the provider.
4.18 (b) A health information exchange maintaining a record locator service must
4.19maintain an audit log of providers accessing information in a record locator service that
4.20at least contains information on:
4.21 (1) the identity of the provider accessing the information;
4.22 (2) the identity of the patient whose information was accessed by the provider; and
4.23 (3) the date the information was accessed.
4.24 (c) No group purchaser may in any way require a provider to participate in a record
4.25locator service as a condition of payment or participation.
4.26 (d) A provider or an entity operating a record locator service must provide
4.27a mechanism under which patients may exclude their identifying information and
4.28information about the location of their health records from a record locator service. At
4.29a minimum, a consent form that permits a provider to access a record locator service
4.30must include a conspicuous check-box option that allows a patient to exclude all of the
4.31patient's information from the record locator service. A provider participating in a health
4.32information exchange with a record locator service who receives a patient's request to
4.33exclude all of the patient's information from the record locator service or to have a specific
4.34provider contact excluded from the record locator service is responsible for removing that
4.35information from the record locator service.
5.1 Sec. 8. Minnesota Statutes 2012, section 144.295, subdivision 1, is amended to read:
5.2 Subdivision 1. Methods of release. (a)Notwithstanding section
144.293,
5.3subdivisions 2 and 4 In addition to release or disclosure of health records authorized
5.4under section 144.293, health records may be released to an external researcher solely for
5.5purposes of medical or scientific research only as follows:
5.6 (1) health records generated before January 1, 1997, may be released if the patient
5.7has not objected or does not elect to object after that date;
5.8 (2) for health records generated on or after January 1, 1997, the provider must:
5.9 (i) disclose in writing to patients currently being treated by the provider that health
5.10records, regardless of when generated, may be released and that the patient may object, in
5.11which case the records will not be released; and
5.12 (ii) use reasonable efforts to obtain the patient's written general authorization that
5.13describes the release of records in item (i), which does not expire but may be revoked or
5.14limited in writing at any time by the patient or the patient's authorized representative;
5.15 (3) the provider must advise the patient of the rights specified in clause (4); and
5.16 (4) the provider must, at the request of the patient, provide information on how the
5.17patient may contact an external researcher to whom the health record was released and
5.18the date it was released.
5.19 (b) Authorization may be established if an authorization is mailed at least two
5.20times to the patient's last known address with a postage prepaid return envelope and a
5.21conspicuous notice that the patient's medical records may be released if the patient does
5.22not object, and at least 60 days have expired since the second notice was sent.
1.3amending Minnesota Statutes 2012, sections 72A.501, subdivision 4; 72A.502,
1.4subdivision 6; 144.291, subdivision 2; 144.293, subdivisions 2, 3, 5, 8; 144.295,
1.5subdivision 1.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. Minnesota Statutes 2012, section 72A.501, subdivision 4, is amended to read:
1.8 Subd. 4. Authorization; noninsurers. If an authorization is submitted to an insurer,
1.9insurance-support organization, or insurance agent by a person other than an insurer,
1.10insurance-support organization, or insurance agent, the authorization must be dated
1.11 signed by the person, and
1.12 is valid for one year, or for a period specified in the authorization, or for a period as
1.13provided in law.
1.14 Sec. 2. Minnesota Statutes 2012, section 72A.502, subdivision 6, is amended to read:
1.15 Subd. 6. Other laws or order. Personal or privileged information may be disclosed
1.16without a written authorization if permitted or required by another state or federal law or
1.17 regulation or in response to a facially valid administrative or judicial order, including a
1.18search warrant or subpoena.
1.19 Sec. 3. Minnesota Statutes 2012, section 144.291, subdivision 2, is amended to read:
1.20 Subd. 2. Definitions. For the purposes of sections
1.21terms have the meanings given.
1.22 (a) "Group purchaser" has the meaning given in section
2.1 (b) "Health information exchange" means a legal arrangement between health care
2.2providers and group purchasers to enable and oversee the business and legal issues
2.3involved in the electronic exchange of health records between the entities for the delivery
2.4of patient care.
2.5 (c) "Health record" means any
2.6
2.7
2.8
2.9 (d) "HIPAA" means the Health Insurance Portability and Accountability Act of 1996,
2.10title II, subtitle F, as amended and including federal regulations adopted under that act.
2.11
2.12gender, parent's or guardian's name regardless of the age of the patient, and other
2.13nonclinical data which can be used to uniquely identify a patient.
2.14
2.15identified as the subject of the health records.
2.16
2.17needed to preserve life, prevent serious impairment to bodily functions, organs, or parts,
2.18or prevent placing the physical or mental health of the patient in serious jeopardy.
2.19
2.20a provider for treatment or examination of a medical, psychiatric, or mental condition,
2.21the surviving spouse and parents of a deceased patient, or a person the patient appoints in
2.22writing as a representative, including a health care agent acting according to chapter 145C,
2.23unless the authority of the agent has been limited by the principal in the principal's health
2.24care directive. Except for minors who have received health care services under sections
2.26person acting as a parent or guardian in the absence of a parent or guardian.
2.27
2.28 (1) any person who furnishes health care services and is regulated to furnish the
2.29services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148D, 148F, 150A,
2.30151, 153, or 153A;
2.31 (2) a home care provider licensed under section
2.32 (3) a health care facility licensed under this chapter or chapter 144A; and
2.33 (4) a physician assistant registered under chapter 147A.
2.34
2.35information that directs providers in a health information exchange to the location of
2.36patient health records held by providers and group purchasers.
3.1
3.2subdivision 3
3.3 Sec. 4. Minnesota Statutes 2012, section 144.293, subdivision 2, is amended to read:
3.4 Subd. 2. Patient consent to release of records. A provider, or a person who
3.5receives health records from a provider, may not release a patient's health records to a
3.6person
3.7 (1) without a signed and dated consent from the patient or the patient's legally
3.8authorized representative authorizing the release;
3.9 (2) unless permitted or required under HIPAA or specific authorization in other
3.10applicable federal or state law; or
3.11 (3) without a representation from a provider that holds a signed and dated consent
3.12from the patient authorizing the release.
3.13 Sec. 5. Minnesota Statutes 2012, section 144.293, subdivision 3, is amended to read:
3.14 Subd. 3. Release from one provider to another. In addition to release or disclosure
3.15of health records authorized under subdivision 2, a patient's health record, including, but
3.16not limited to, laboratory reports, x-rays, prescriptions, and other technical information
3.17used in assessing the patient's condition, or the pertinent portion of the record relating to
3.18a specific condition, or a summary of the record, shall promptly be furnished to another
3.19provider upon the written request of the patient. The written request shall specify the name
3.20of the provider to whom the health record is to be furnished. The provider who furnishes
3.21the health record or summary may retain a copy of the materials furnished. The patient
3.22shall be responsible for the reasonable costs of furnishing the information.
3.23 Sec. 6. Minnesota Statutes 2012, section 144.293, subdivision 5, is amended to read:
3.24 Subd. 5. Exceptions to consent requirement. In addition to release or disclosure of
3.25health records authorized under subdivision 2, this section does not prohibit the release of
3.26health records:
3.27 (1) for a medical emergency when the provider is unable to obtain the patient's
3.28consent due to the patient's condition or the nature of the medical emergency;
3.29 (2) to other providers
3.30current treatment of the patient; or
3.31 (3) to a health care facility licensed by this chapter, chapter 144A, or to the same
3.32types of health care facilities licensed by this chapter and chapter 144A that are licensed
3.33in another state when a patient:
4.1 (i) is returning to the health care facility and unable to provide consent; or
4.2 (ii) who resides in the health care facility, has services provided by an outside
4.3resource under Code of Federal Regulations, title 42, section 483.75(h), and is unable
4.4to provide consent.
4.5 Sec. 7. Minnesota Statutes 2012, section 144.293, subdivision 8, is amended to read:
4.6 Subd. 8. Record locator service. (a) In addition to release or disclosure of health
4.7records authorized under subdivision 2, a provider or group purchaser may release patient
4.8identifying information and information about the location of the patient's health records
4.9to a record locator service without consent from the patient, unless the patient has elected
4.10to be excluded from the service under paragraph (d). The Department of Health may not
4.11access the record locator service or receive data from the record locator service. Only a
4.12provider may have access to patient identifying information in a record locator service.
4.13Except in the case of a medical emergency, a provider participating in a health information
4.14exchange using a record locator service does not have access to patient identifying
4.15information and information about the location of the patient's health records unless the
4.16patient specifically consents to the access. A consent does not expire but may be revoked
4.17by the patient at any time by providing written notice of the revocation to the provider.
4.18 (b) A health information exchange maintaining a record locator service must
4.19maintain an audit log of providers accessing information in a record locator service that
4.20at least contains information on:
4.21 (1) the identity of the provider accessing the information;
4.22 (2) the identity of the patient whose information was accessed by the provider; and
4.23 (3) the date the information was accessed.
4.24 (c) No group purchaser may in any way require a provider to participate in a record
4.25locator service as a condition of payment or participation.
4.26 (d) A provider or an entity operating a record locator service must provide
4.27a mechanism under which patients may exclude their identifying information and
4.28information about the location of their health records from a record locator service. At
4.29a minimum, a consent form that permits a provider to access a record locator service
4.30must include a conspicuous check-box option that allows a patient to exclude all of the
4.31patient's information from the record locator service. A provider participating in a health
4.32information exchange with a record locator service who receives a patient's request to
4.33exclude all of the patient's information from the record locator service or to have a specific
4.34provider contact excluded from the record locator service is responsible for removing that
4.35information from the record locator service.
5.1 Sec. 8. Minnesota Statutes 2012, section 144.295, subdivision 1, is amended to read:
5.2 Subdivision 1. Methods of release. (a)
5.3
5.4under section 144.293, health records may be released to an external researcher solely for
5.5purposes of medical or scientific research only as follows:
5.6 (1) health records generated before January 1, 1997, may be released if the patient
5.7has not objected or does not elect to object after that date;
5.8 (2) for health records generated on or after January 1, 1997, the provider must:
5.9 (i) disclose in writing to patients currently being treated by the provider that health
5.10records, regardless of when generated, may be released and that the patient may object, in
5.11which case the records will not be released; and
5.12 (ii) use reasonable efforts to obtain the patient's written general authorization that
5.13describes the release of records in item (i), which does not expire but may be revoked or
5.14limited in writing at any time by the patient or the patient's authorized representative;
5.15 (3) the provider must advise the patient of the rights specified in clause (4); and
5.16 (4) the provider must, at the request of the patient, provide information on how the
5.17patient may contact an external researcher to whom the health record was released and
5.18the date it was released.
5.19 (b) Authorization may be established if an authorization is mailed at least two
5.20times to the patient's last known address with a postage prepaid return envelope and a
5.21conspicuous notice that the patient's medical records may be released if the patient does
5.22not object, and at least 60 days have expired since the second notice was sent.
